The Controversy of Vaccines - Protecting Our Herd Jackie ...

[Pages:18]Running head: THE CONTROVERSY OF VACCINES ? PROTECTING OUR HERD

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The Controversy of Vaccines - Protecting Our Herd Jackie Michl

Indiana State University

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Table of Contents Abstract.........................................................................................................3 Introduction..................................................................................................4-8

Achievements of vaccines How do vaccines work? Benefits vs Risks Policymaking in Vaccination Mandates Thesis/Problem Statement....................................................................................8 Literature Review..........................................................................................9-15 Why do controversies of vaccines exist? Is there an association between vaccines and autism? Is there a cultural phenomenon that establishes this controversy, specifically with vaccines and autism? Conclusion................................................................................................15-16 References.................................................................................................17-18

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Abstract This literature review involves the controversy of vaccines and what causes this controversy. The research that linked autism to the measles, mumps, and rubella (MMR) vaccine is flawed and later deemed not credible, but it created a cultural phenomenon which influences herd immunity. The goal of this thesis is to answer the questions: Why do controversies of vaccines exist? Is there an association between vaccines and autism? Is there a cultural phenomenon that establishes this controversy, specifically with vaccines and autism? Based on the literature review of the research done behind this controversy, there is no scientific evidence that vaccines are harmful or are linked to autism. They are the most successful, medical phenomenon and based on one defective case study, the anti-vaccination movement developed. This movement needs to be eradicated by making the exemption clause harder in order to save herd immunity.

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Introduction Achievements of vaccines

Vaccines are considered the most cost-effective and successful medical phenomenon that was ever generated. "A recent publication from the US Centers for Disease Control and Prevention suggests that this distinction continues to hold, reporting that for children born in the United States during the period 1994?2013 vaccines will have prevented 322 million illnesses, 21 million hospitalizations, and 732,000 premature deaths, saving $295 billion in direct medical costs and $1.38 trillion in total societal costs" (Rappuoli, 2014). However despite these statistics, there is still a negative connotation with vaccines which affects herd immunity and can potentially cause outbreaks that lead to epidemics. How do vaccines work?

Vaccines are made up of antigens. Antigens can be foreign bodies or are found within the body which creates the body's immune system to produce antibodies. These antibodies fight off the disease. Vaccines introduce a weakened portion of a particular disease that the body can then adapt to fight off the disease. This creates the body to be immune to this disease because of the buildup of antibodies that the body produces when the vaccine is given. Vaccines are a safe way for children to be introduced to a disease without having the harmful effects of the disease (Center for Disease Control and Prevention, 2014).

The immune system can fight disease off to an extent. Vaccines are used to introduce a virus to the body; therefore the body's immune system can create antibodies which then fight off the disease. There are four different concepts of immunity: immune specificity, immune memory, cellular immunity, and humoral immunity. These four concepts are a part of the body's acquired immunity.

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Immune specificity is when the body has an immune response to a specific strand of an infection. This means that the body can be immune to smallpox, but not chicken pox or vice versa. The body learns to fight off one strand of a disease, but if the disease mutates, the immune cells cannot recognize the virus. Because of immune specificity, the flu vaccine must be taken every year. The flu virus has the ability to change its form causing the body to not recognize it which means it takes longer to create the correct antibodies to fight the virus off (Link, 2005).

The second concept of acquired immunity is immune memory. The body recognizes a virus the second time it is introduced to it. This means that the body can fight off a virus faster the more times it has been infected by it. There is in fact a problem with immune memory. For instance, if antibiotics are used to treat an infection, the body cannot respond properly in order to create this memory of the infection. The antibiotics will treat the infection, but the body is more likely to be reinfected because it hasn't learned to fight it off competently (Link, 2005).

The third and fourth type of acquired immunity is cellular immunity and humoral immunity and is cohesive. In cellular immunity, the cells recognize that there is a foreign virus or infection in the body and therefore, the body creates antigens to attack the foreign bodies. Cellular immunity plays a vital role in the last concept of humoral immunity. When the cells identify a foreign body in cellular immunity, humoral immunity allows the antibodies to circulate in the blood to find the infection. It then coats the foreign body and attacks it, killing it (Link, 2005).

Benefits vs Risks In the United States, there has recently been a resurgence of contagious diseases, such as

pertussis, that can only be explained by the lack of vaccines administered to children. According

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to Risk Analysis: An International Journal (2014), "In 2010, for instance, a total of 27,550 cases of pertussis, or whooping cough, were reported, which was a 250% increase from the 7,867 cases in 2000. The number decreased in 2011, with a total of 15,216 reported cases, along with some sporadic outbreaks in several states. However, in 2012 nearly 41,000 cases were reported to the Centers for Disease Control and Prevention (CDC), which made 2012 a record year for whooping cough in the United States" (Song, 2014). This outbreak of pertussis could have easily been decreased drastically or avoided completely by creating herd immunity within the population.

According to an interview with Elizabeth Miller, there are risks and benefits of vaccines. Miller's current occupation is a Consultant Epidemiologist at the Immunisation Hepatitis and Blood Safety Department. She has also founded the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety and served on the WHO Strategic Advisory Group of Experts for six years. In the 1970s, a massive decline in the United Kingdom of the vaccination for pertussis, also known as whooping cough, caused a major increase in the disease itself. This decline of the vaccination was because of the allegations that the vaccine caused neurological disorders and was inefficient in protecting against pertussis. The result of children not receiving the pertussis vaccination created an epidemic. Miller in turn conducted research over this epidemic that confirms the vaccine is safe and effective against pertussis creating a positive view on the vaccination once again (Miller, 2015).

Another outbreak that occurred, in the United States, is the measles outbreak. Song (2014) states, "In fact, during 2011 alone, a total of 222 measles cases and 17 measles outbreaks were reported to the CDC, compared with a median of 60 cases and four outbreaks reported annually from 2001 to 2010." Again this outbreak could have been avoided by simply creating

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herd immunity in the population. Herd immunity is when at least 95% of the population has been vaccinated against the disease which creates the disease from spreading. Herd immunity also protects unvaccinated individuals, which includes newborns, from a disease because the disease is controlled in a small portion of the community. Creating herd immunity may become a problem if and only if the virus mutates into a different strand that the body has not learned to fight off.

Policymaking in Vaccination Mandates and Vaccine Ethic Even though the research behind vaccines' negative effects is very little, this idea can

influence policy making. Based on Orenstein and Yang's research, policies should be based on evidence instead of personal opinion and politics. The mandatory vaccination laws for children have been the most successful at preventing epidemics from occurring. The mandatory vaccines are diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, hepatitis B, and varicella. The reason for this low incidence rate is that policymakers declare benefits from vaccines and identify vaccinations as the social norm. All 50 states require children to be vaccinated before attending school. However, some states have exemptions from this vaccination law which can be acquired based on religion, philosophical, and medical reasons. The goal of childhood vaccination laws is to create herd immunity and eliminate diseases completely (Orenstein and Yang, 2015). However, this mandatory vaccination law can become a problem if a child is homeschooled or if vaccines are deemed unethical by spiritual or physiological beliefs.

California is one of the states with the lowest vaccination population due to this antivaccination movement. This is due to parents' physiological or religious beliefs along with the belief that vaccines are unsafe for their children. A measles outbreak started at Disneyland in

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California and because of the high rates of unvaccinated children, this caused measles to spread rapidly. The current mandatory laws put in place for all school aged children to be vaccinated are being taken advantage of because of the exemption clause included in the policy. Nonvaccinators choose to use this exemption clause as an excuse to not vaccinate their children therefore, lawmakers are responsible for revising or changing the mandatory vaccination laws to ensure public health and to stop the rapid spread of these diseases that vaccines prevent from occurring. According to the Boston College Law Review (2016), "Lawmakers must tighten the valve on compulsory vaccination requirements in order to prevent the deterioration of the nation's health. Laws should reflect the need for diligence in vaccination practices and prevent unnecessary or unwarranted medical, religious, and philosophical exemptions" (Lobo, 2016). The laws need to be stricter and more difficult for the exemption of the mandatory vaccination law which will decrease the amount of parents deciding against vaccination.

Thesis/Problem Statement In this thesis, I will investigate the basis and prevalence of the controversies surrounding vaccines and examine the data and claims based on this data that brings forth the controversy of vaccines. Specifically, I will address the following research questions. Why do controversies of vaccines exist? Is there an association between vaccines and autism? Is there a cultural phenomenon that establishes this controversy, specifically with vaccines and autism? Through these questions, the research that has been done shows that even through the successful eradication of diseases, there is an anti-vaccination movement that is harming herd immunity and increasing the incidence rate of these diseases. The anti-vaccination movement needs to be stopped by legislatures and public health professionals in order to protect herd immunity.

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